AbstractWe Present a unique case of tracheobronchial compression secondary to a vascular ring associated with a large arch and descending thoracic aortic aneurysm. While we would typically advocate for open repair for this rare condition, emergent operative intervention was not considered the best option due to the physiologic state of the patient and anatomic constraints that warranted further planning. We propose that Veno-venous Extracorporeal Membrane oxygenation can serve as bridge to therapy and allow time for operative planning and physiologic stabilization.